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Tuesday, December 15, 1998 Published at 16:08 GMT


Controversy over fertility wonder technique

The treatment has proved a success

ICSI - intra-cytoplasmic sperm injection - treatment has been hailed as one of the reasons behind the continuing rise in in-vitro fertilisation (IVF) success rates.

ICSI is where sperm is injected directly into the egg.

However, some research has raised concerns that use of the technique could lead to babies being born with genetic defects.

The fear is that men with a low sperm count could pass that characteristic on to their child, or perhaps raise the risk of the child developing any one of a range of genetic diseases, from Down's syndrome to cystic fibrosis.

This is because infertile men are 10 times more likely than the average man to carry these genetic abnormalities.


Some doctors have called for counselling for patients about to undergo treatment to be made compulsory so they are aware of the potential risks.

But other researchers suggest that any risk is extremely low and that reports to the contrary are scaremongering.

[ image: Professor Robert Winston:
Professor Robert Winston: "Small group affected"
Professor Lord Robert Winston, of Imperial College Medical School, said: "It's only a small group of men who may be at risk of (such) a mutation."

He said that genetic testing of the parents prior to treatment was not an easy task and it did not always reveal the mutation on the chromosome.

However, he said: "In most units I am aware of, this test is done in anybody whether there is the slightest risk, and it's fairly routine in most good units doing ICSI."

He said patients should be aware of the evidence of the risks to babies conceived through IVF.

"We have in Europe 10,000 babies and the incidence of Down's syndrome is no greater than in the general population of people who are conceiving normally - that's the evidence."

He said that the fear of genetic defects as a result of ICSI was based on "limited evidence" produced by "quite dubious" research.

He added that it "flies against all the other evidence we're getting from the rest of Europe".


The Human Fertilisation and Embryology Authority's (HFEA) annual report, published on Tuesday, showed a rise in both the use and success of ICSI treatment.

At the moment the authority restricts the types of ICSI that can be practised in the UK. In particular, the use of sperm cells rather than ejaculated sperm is banned.

Ruth Deech, chairman of the authority said: "Concerns have been raised regarding the genetic consequences of the use of ICSI.

"We have considered these issues and this year issued information to clinics addressing the risks of ICSI and suitable information for patients."

She added that the HFEA was keen to join others to follow up the progress of children born as a result of ICSI treatment.

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